Guest post by Stephanie Morris, PhD Candidate at Durham University
My time at The University of Wollongong has been one of the
biggest learning experiences so far on my Overseas Institutional Visit to
Australia. My conversations with scholars there have led me to think more
critically and question the status quo regarding physical activity, health and
obesity. I had many conversations with Professor
Jan Wright that made me realise the way in which physical activity is often
promoted may have some unintended consequences for the health and wellbeing of
those whose behaviours public health initiatives constantly seek to change.
The University of Wollongong |
Many academics and practitioners stress the importance of
understanding the political economy of health and health inequalities yet it appears
that the media and other discourses in our neoliberal society remain focused on
stigmatising individual bodies and their behaviours. I came across an article
in The Spectator (a conservative magazine) recently entitled, Our
NHS will sink under the weight of Britain’s fatties. The title
alone got my blood curdling but one paragraph written by Dr Dawn Harper stood
out in particular. It went as follows:
If you are a woman with a
waist greater than 32in (80cm) or a man with a waist greater than 37in (94cm)
you are at risk of type 2 diabetes. If you are a woman with a waist circumference
greater than 35in (88cm) or a man with a waist greater than 40in (102cm) then
your risk is very high… For your sake and for the sake of our beloved
NHS, take this as a warning shot across your bow and get yourself on a healthy
living plan.
Now, the first thing I thought about this extract was how
fear mongering and morally loaded its tone was. The emphasis is put on the
individual for being a bad citizen, immorally and self-indulgently sinking the
NHS. Yet, causations and prevalence of obesity and diabetes is much more
complex than a waist circumference category. The key question that I wish to
raise here stems from the work of two critical scholars, Gard and Wright (2005),
whose work is part of the literature critiquing the ‘obesity epidemic’, the
link between body size and diseases like diabetes, and health education
curriculums. They ask whether the prevalence of such obesity discourses are
actually more connected with the morality included in cultural attitudes
concerning fatness than about the clear communication of objective and
conclusive scientific knowledge. I am not suggesting that there is no reason for
some focus on body weight and size, nor am I attempting to condemn all
quantitative research in this area. However, I am questioning what implications
such a focus on the body might have for people, and future research and policy.
First, many have argued that focusing on the individual body distracts us as
researchers and citizens from looking at wider structural issues and health
inequalities that need to be researched and addressed. Second, others show
obesity discourses and 'Healthism' (a term coined by Crawford (1980) to describe a discourse where individuals are held morally responsible for
their own health. Individuals then self-monitor and manage their health by
objectifying the body.) fuel body dissatisfaction, feelings of guilt and eating
disorders, thus negatively impacting on the wellbeing of children and young
people.
Positive vibes from a hostel in Sydney |
Due to these negative consequences on people's wellbeing I
ask what we as scholars, practitioners and third sector workers in the field of
public health really consider ‘health’ to be? Do we consider 'health' to be “a
state of complete physical, mental and social wellbeing and not merely the
absence of disease or infirmity” (The WHO definition)? Or do we view ‘healthy’
as appearing as an active and slim body? There are movements away from focusing
on weight and body size, including Health
at Every Size (HAES) – which Peter van der Graaf also writes about in this blog
post – that focuses on promoting happiness in eating and an enjoyment of
movement in life. Although HAES has been critiqued by many I wonder if some of
its elements can be valuable. I do not think continually worrying about one’s
body or fat composition is a ‘healthy’ way to grow up or live, as I don’t think
it helps achieve “physical, mental and social wellbeing”. Moreover, perhaps if
we stop fixating on the body and move away from changing individual behaviours
we might consider societal inequalities more and help reduce inequalities that
constrain people’s daily lives. What do you think?
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